epilepsy

Question 1

if someone has 1 seizure after how long can they drive again in a car and HGV

Answer 1

car - 6 months

HGV - 5 years

Question 2

if someone has epilepsy what is the criteria for them to drive a car and HGV

Answer 2

car - 1 year seizure free

HGV - 10 years seizure free and off medication

Question 3

what is epilepsy

Answer 3

a tendency to have recurrent, usually spontaneous epileptic seizures

epileptic seizures - abnormal discharge of electricity that happens spontaneously

Question 4

what is more common in epilepsy an excitatory or inhibiotry electrical discharge

Answer 4

excitatory

Question 5

incidence of epilepsy

Answer 5

50-80/100,00 incidence a year
1/100-200 prevalence
most common neurological disorder

THOSE WITH EPILEPSY AT RISK OF SUICIDE

Question 6

What type of seizures are seen in focal epilepsy

Answer 6

focal that can progress to general seizures

Question 7

how would you describe a seizure if someone loses consciousness

Answer 7

discognitive

Question 8

what are the different kinds of generalised seizures

Answer 8

absence
myotonic
atonic
tonic
tonic clonic

Question 9

what lobe is invloved in sensory focal seizures

Answer 9

parietal lobe

Question 10

what lobe is involved visual hallucinations or de je vu

Answer 10

temporal lobe

Question 11

if focal seizure is motor what lobe is involved

Answer 11

frontal lobe

Question 12

what age are the different type of epilepsy seen at

Answer 12

generalise - younger as tend to be genetic

partial - older as time to accumulate injury eg MS, tumour, trauma

Question 13

treatment for generalised seizure 1st and 2nd line

Answer 13

1at - Sodium Valproate

2nd - Lamotrigene

Question 14

treatment for focal epilepsy 1st and 2nd line

Answer 14

1st - Carbamazapine

2nd - Lamotrigene

Question 15

mechanism of action for carbamazepine and lamotrigeen

Answer 15

sodium channel blocker

Question 16

mechanism of action for sodium valproate

Answer 16

enhances GABA synthesis

Question 17

what can be given alongside sodium valproate to enhance its efficacy

Answer 17

lamotrigene

Question 18

after carbamazpine and lamotrigene what are examples of drugs that can be added on

Answer 18

oxycarbazepine
levetoracitam 
topiramate
gabapentin
pregabalin
clonazepam 
phrnytoin

Question 19

what is given 2nd line in absent seizures

Answer 19

ethosuximide

Question 20

what is given 2nd line in myoclonic seizure

Answer 20

levetoracitam

Question 21

sodium valproate side effects

Answer 21

teratogenic
weight gain
hair loss
fatigue

LOTS OF OTHERS

Question 22

carbamazepine side effects

Answer 22

dizziness

Question 23

side effect of lamotrigene

Answer 23

stevens johnson syndrome

Question 24

topiramate side effects

Answer 24

weight loss and psychiatric problems

Question 25

what is STATUS EPILEPTICUS

Answer 25

recurrent epileptic siezures without full recovery of consciousness lasting more than 30 mins

Question 26

after how many mins of status is treatment initiated

Answer 26

10 mins

Question 27

what are the different types of status epilepticus and explaine each a little

Answer 27

generalised convulsive status epilepticus (tonic clonic )
non convulsive status (partial epilepticus -conscious but not with it )
epilepsia partialis continua - continuous focal seizures but retained consciousness

Question 28

what is the worst kind of status

Answer 28

generalise convulsive status

excitotoxicity and neuronal death after glutamate release

Question 29

management of a convulsive status epilepticus

Answer 29

after 10 mins 
benzo admin 
if doesn't work benzo again 
phenytoin( if unavail then Na VAlproate or levitoracitam )
if nto CALL ICU

Question 30

what benzos and what dose can be given in status

Answer 30

IV lorazepam 4mg
buccal midazolam 10mg
rectal diazepam 10mg

Question 31

what is name for a functional seizure

Answer 31

psychogenic non-epileptic attack disorder